Type 3 diabetes (T3D), defined by the concurrence of type 2 diabetes and age-related cognitive impairment, is linked to progressive deterioration in both cognitive and physical function. Emerging evidence suggests that functional exercise training prescribed in relation to individualized lactate thresholds may enhance neurocognitive and physical adaptations by matching exercise intensity to individual metabolic capacity and systemic organ cross-talk. Randomized controlled trial will examine the effects of long-term, lactate-threshold–based functional training on cognitive and physical function in older adults with T3D, highlighting the role of exercise intensity in optimizing outcomes. Sixty-six adults aged 60–80 years with Type 3 diabetes and cognitive impairment, assessed by the Mini-Mental State Examination, will be recruited from the Chaharmahal and Bakhtiari Diabetes Association and randomly assigned to three groups. The intervention group will undertake a six-month, individualized high-intensity functional training program combining supervised and home-based sessions. Primary outcomes include changes in cognitive performance and physical function assessed using validated and standardized measures. It is hypothesized that lactate-threshold–guided functional exercise at tailored intensities will lead to significant improvements in both cognitive and physical function, emphasizing the critical role of exercise intensity in modulating neurocognitive and functional adaptations in elderly individuals with type 3 diabetes. This study aims to provide robust evidence for intensity-specific, lactate-threshold–based exercise prescriptions in this population.
